• 한국간호교육학회지
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• 제16권1호
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• pp.111-120
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• 2010

Purpose: The purpose of this study was to evaluate the correct use of inhalers and to examine the patients characteristics affecting correct use of inhalers in patients with obstructive pulmonary disease. Method: Subjects were 280 patients with obstructive pulmonary disease who visited the internal pulmonary outpatient departments in 2 university hospitals in Korea. Inhaler use of each patient was assessed using a checklist recommended by the National Asthma Education and Prevention Program Expert Panel. Result: Most subjects used a DPI or MDI. The overall mean score of correct use was 72.09. Most subjects responded they knew well how to use their inhalers. Most frequent error was 'not fully exhaling before inhalation'. A younger age, higher educational level, living with family, and awareness of inhaler use were significantly associated with correct use of inhalers. Conclusion: The findings of this study showed that most of patients were unable to use inhalers correctly even though they had prior educational experiences. Regular assessing of inhaler use and adequate inhaler education considering patients characteristics by nurses are needed.

• 대한간호학회지
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• 제40권2호
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• pp.202-212
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• 2010

Purpose: This study was done to evaluate the effectiveness of an education program for patients with asthma who use inhalers. Methods: The research design for this study was a non-equivalent control group quasi-experimental study. Participants in this study were 36 patients for the control group, and 43 patients for the experimental group. The experimental group participated in the education program. The control group received the usual care. Data were collected before and 1 month and 2 months after the program finished and were analyzed using the SPSS 12.0 program. Results: The experimental group had significantly higher scores of knowledge of inhalers, and inhalation technique compared to the control group. However, no significant differences were found between two groups for PEFR, asthma instability, and satisfaction with inhalers. Conclusion: According to the results, the education program was effective in improving knowledge of inhalers, and inhalation technique. Therefore, it is recommended that this education program be used in clinical practice as an effective nursing intervention for patients with asthma on inhalers.

• 기본간호학회지
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• 제15권4호
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• pp.418-427
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• 2008

Purpose: This study was done to investigate the relationship of knowledge related to disease, awareness and practice of inhaler use in asthmatic patients. Method: The participants in this research were 124 patients with asthma who used inhalers, and were admitted to hospital or attended outpatient asthmatic clinics. Data were collected using a self-administered questionnaire which consisted of demographic characteristics, illness-related characteristics, and tools to measure knowledge of disease, awareness and practice related to inhaler use. Results: Knowledge related to disease was statistically significantly different for age (p<.001) and marital status (p=.017). The mean score for awareness of inhaler use was significantly higher than the mean score for practice in inhaler use (p<.001). There were significant correlations between awareness and practice of inhaler use (p<.001), knowledge related to disease and awareness of inhaler use (p<.001), and knowledge related to disease and practice of inhaler use (p<.001). Conclusion: Results indicate that due to the variation in degree of illness in patients with asthma, there is a need to develop appropriate education programs for people of different ages and also precise ${\alpha}$ II content for use of inhalers method of checking capacity washing and storing as well as directions about different kinds of the inhalers.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.91-98
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• 2018

When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.46-54
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• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 2003년도 춘계 Symposioum
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• pp.23-24
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• 2003

• 약학회지
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• 제47권4호
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

• 한국임상약학회지
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• 제24권1호
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• pp.26-32
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• 2014

Purpose: The aim of this study was to investigate drug prescription patterns for the treatment of asthma and chronic obstructive pulmonary disease (COPD) patients in Korea. Methods: Ambulatory adult patients who were diagnosed and received treatment for the asthma (ICD-10 code J45) or COPD (ICD-10 code J44) from January 2009 to September 2011 in two independent secondary hospitals in Korea were enrolled in this study. Prescribed drug lists were generated based on the evidence-based guidelines and prescribed drug dosage forms were identified from the patient medical records and computerized drug prescription databases of the study centers. Results: Total numbers of asthma and COPD patient enrolled in this study were 2,432 and 2,615, respectively. Individual prescription-based accumulated numbers of patient were 12,021 for asthma and 16,584 for COPD. The most commonly prescribed three drugs were oral predisolone, oral formoterol and oral montelukast for asthma and oral formoterol, oral doxofylline and inhaled tiotropium for COPD. Frequencies of oral drugs were 83.4% and 63.3% while inhalers were 16.4% and 30.2%, for asthma and COPD, respectively. Conclusion: The oral treatment was prescribed more in asthma and COPD patients than inhalers. To enhance the compliance of evidence-based guidelines for these chronic airway diseases, more realistic and specific strategies to increase the use of inhalers recommended as primary treatment options for asthma and COPD would be required.

• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.377-384
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• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

• Clinical and Experimental Pediatrics
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• 제45권2호
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• pp.192-198
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• 2002

목 적 : 천식치료에 사용되는 DPI와 BAM는 소아의 연령과 증상 정도에 따라 기구의 올바른 사용과 선택이 중요하다. 몇가지 종류의 흡입기가 개발되었으며 각기 다른 흡입기의 저항을 고려하여 사용을 권고하게 된다. 이에 본 저자들은 In-Check Inspiratory Flow $Meter^{(TM)}$ 기구를 사용하여 네가지 흡입기 종류(TFI, MUD, BAM, Auto)의 흡입량을 측정하여 사용 가능한 연령을 알아보고자 본 연구를 시행하였다. 방 법 : 2000년 7월부터 2001년 5월까지 포천중문의대 분당 차병원에 입원한 호흡기 감염이 없는 3세에서 6세 사이(mean $57{\pm}12.9$개월)의 연령 93명(남/여 59/34)을 대상으로 하였다. 검사 대상자에게 완전히 숨을 내쉬라고 한 후, 마우스피스를 물고 강하고 빠르게 흡입하도록 하여 커서가 가리킨 곳의 PIF를 체크하였다. 세번 측정하여 가장 높은 수치를 PIF로 정하였다. 3세부터 4세를 A군, 4세부터 5세를 B군, 5세부터 6세까지를 C군, 6세부터 7세까지를 D군으로 하였다. 각각의 대상환자는 31명, 32명, 18명, 12명이었다. 결 과 : A군 9명(29%), B군 5명(16%), C군 1명(6%)이 교육에도 불구하고 흡입하지 못하였다. D군 12명은 모두 흡입하였다. 키, 몸무게, 개월수와 PIF의 상관관계는 0.5에서 0.7의 높은 상관계수를 보였다(P<0.05). 단순회귀분석으로 TFI의 사용 가능한 연령, 키, 몸무게는 각각 8년 7개월, 142 cm, 32 kg이었으며, MUD는 2년 10개월, 92 cm, 12 kg이었다. BAM는 1년 8개월, 83 cm, 8.5 kg이었으며 Auto는 2년 8개월, 91 cm, 11 kg에서 흡입이 가능하면 치료 가능한 흡입력을 보여주었다. 결 론 : PIF는 개월수, 키, 몸무게 변수로 예측가능하며, 3세 이후 소아 71% 에서 교육을 통하여 MUD, BAM, Auto로 약물을 흡입할 수 있었다.